Another child in my son’s daycare is sick with RSV, what is this and will my child get sick?

Respiratory Syncytial Virus or RSV is a highly contagious, common virus that causes infection of the respiratory tract. This virus is most prevalent during the winter months; however, it can be seen year round in many areas.

Infection with this virus is extremely common, data from the Center for Disease Control (CDC) states that nearly all children will be affected with RSV by the time they are 2 years old. RSV is the most common cause of bronchiolitis (inflammation of the small airway passages in the lungs) and pneumonia in children less than 1 year of age. Approximately 4-5 million children develop an RSV infection each year. More than 125,000 children are admitted to the hospital because of an RSV infection each year. RSV is also more common in children who attend daycare and in children who are exposed to second hand smoke.

Photo from http://www.cdc.gov/Features/dsRSV/

What are the symptoms?

RSV can affect people of all ages and having an illness caused by the virus once does not mean you will be immune to it in the future.  Symptoms of RSV can range from mild, especially in older children and adults, to severe.

Common symptoms can include:

  • Cough, runny nose, sneezing, fever, nasal congestion, wheezing, and difficulty breathing (especially for newborns and very young infants).
  • Infants and children with high fevers, trouble breathing, appear ill or are less active should always be evaluated by a physician.
  • The time from exposure to showing symptoms ranges from 2-8 days.  Once symptoms begin they can last up to 2 weeks, with symptoms peaking in severity around day often around day 5 to 7

Prevention

Even though nearly every child will have cold-like symptoms due to RSV by the time they are 2, there are steps that you can take to avoid spreading the virus to the children and adults around you.

  • Hand washing – the most important way to prevent the spread of RSV.
    • RSV is spread from person to person by direct contact or by being within a few feet of a sneeze or cough from an individual with the virus.
  • Clean all common areas, including toys, with a disinfectant or soap and water.
    • Ask if your child’s daycare cleans and washes all toys and playing surfaces each day.
    • Avoid sharing cups and utensils.

Treatment

There is no specific treatment for an RSV infection.  Antibiotics, which only kill bacteria, do not work on RSV or other viruses.  There is also no current vaccine to prevent infections with RSV.  Treatment for children infected with RSV is called symptomatic; meaning that only each symptom can be treated.

This includes non-aspirin containing medication like acetaminophen (Tylenol®) to control fever, and frequent nasal suctioning (with a bulb syringe) to control congestion – which helps to prevent breathing difficulties.

Proper nasal suctioning to remove mucus from the nose can prevent severe breathing difficulties. Ask your doctor to show you how to properly suction the nose with a bulb syringe to ensure adequate removal of mucus.

Some patients, including those with underlying respiratory illnesses, like asthma, will benefit from medications which help to open the airways.

Many children will not want to eat as much as they normally do when they are sick.  It is still imperative to ensure adequate hydration while your child is ill. If you child refuses to drink liquids or is urinating less, they should be evaluated immediately by a physician.

A medication called palivizumab is available to help prevent serious RSV infections in children who are at high risk. Examples of high risk children: children less than 2 years of age with chronic lung disease, preterm infants less than 35 weeks gestation, or children with certain types of congenital heart disease. Ask your pediatrician if your child meets criteria for receiving this medication. Even children who receive this medication can still be infected with RSV.

For more information on RSV and what to do if your child has symptoms, please contact your pediatrician.